| NPI | 1932472180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA L REID CEO 770-256-3194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: GA 107-01-071-1) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: GA 107-01-071-1) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2012-02-20 |